24 Sep Spontaneous labour after caesarean section?
Spontaneous labour after caesarean section?
As I had to stop the birth of my daughter after days of induction in hospital and nasty comments from the midwives, followed by a caesarean section, I knew that I would approach everything differently with my second child. So I looked around for a birth centre for my second pregnancy and found the birth centre in Hamm.
I was initially looked after and supported by two, and later by three wonderful midwives. From the beginning, none of them gave me the courage to give birth spontaneously, although I received a lot of opposition and misunderstanding, especially from doctors, because of my previous caesarean section. But that didn't matter to me, because I knew that if I could deliver a baby naturally, then only in this way.
Due to the fear of having to have another induction in hospital, I was given lots of tips on natural induction in consultation with my midwives from the due date onwards and I did this every day, because I longed for the birth every day and was really looking forward to it. When I was a week past my due date and my cervix was already 1cm open at the antenatal check-up, I was able to have an egg-poll solution performed at my request, a natural induction method. I went home full of hope. In addition to lots of exercise, clove oil tampons, massage and a bath, I actually went into labour in the evening. From then on, I was always in dialogue with my midwife Nora, who was on call.
At some point during the night the contractions got so bad that I could no longer stand them at home and it was clear that I now had to go to the birth centre. We informed Nora. My boyfriend and my mum accompanied me. Once there, Nora and a warm, nice-smelling room were waiting for me. Nora looked after me very lovingly. The bath was already running and the light was cosy. First I was given a Buscopan suppository. Then I lay down in the birthing room bed, the cervix was already at 5-6cm and it quickly became apparent that my baby's head was not in the right position and we did some exercises. Unfortunately, I had very painful contractions and my waters suddenly broke during a contraction. Due to the awkward position of the head, I felt a strong urge to push. I went into the bathtub. There I tried to breathe out the contractions, but couldn't suppress the urge to push and pushed loudly several times. During the next vaginal examination, Nora discovered that the cervix and the baby's head were oedematous and the cervix had not opened any further. Due to my previous caesarean section, she advised us to transfer. As I was in a lot of pain and also had a certain amount of anxiety, I agreed to the transfer in consultation with my boyfriend. Fortunately for me, the transfer went quickly and the paramedics were very kind. Nora accompanied me. When we arrived at the hospital, I could already hear the loving voice of the midwife from the delivery room, who came to meet me full of confidence and I was incredibly relieved. Nora did a handover and waited for my boyfriend and my mum, then she said goodbye. I was given laughing gas to tide me over until the epidural came, which didn't help at all. The gynaecologist wanted to take blood samples from our baby, but our midwife said it was more important to give me an epidural first, as the baby would be fine. We agreed to this and refused to have blood taken. I was then given tocolytics and an epidural. The urge to push went away quickly and we waited for me to become pain-free, which took quite a long time. At some point, a gynaecologist came and told me sympathetically that if it came to a caesarean section, it was not my fault and that I had already done everything in my power, but that she still wanted to try everything, as I had come from a birth centre for a reason and she took my wish for a natural birth very seriously.
After a physical examination and ultrasound scan, it was determined that a high standing position made the birth difficult. My baby's head had to be lowered, otherwise a caesarean section would have to be performed. After the epidural was increased and the pain was adjusted, the midwife did a few exercises with my pelvis and then I had to lie like that for a while. I couldn't sleep as I could still feel the contractions despite the epidural. When I was alone with my boyfriend, I cried a lot, I was too worried about having another caesarean section and the fear of having the same severe pain in the postpartum period as I did with my first birth. My boyfriend strengthened me and told me, “No matter what happens, we'll get through it a second time!". At some point, another physical examination followed.
The midwife was thrilled to discover that my cervix was already at 9cm. She told me that the chance of a repeat caesarean had been 90 to 10%, but now there was a 50 to 50%. She called in the gynaecologist and they told me that I now had an hour to fully dilate. The exercise with my pelvis was done again. I was catheterised twice so that I could gather my strength and not have to get up to pee. My cervix opened up to 10cm in less than an hour. A shift change took place and the new, also great midwife and the gynaecologist were with me and I was now allowed to try to push my head down a little during each contraction. Unfortunately, the contractions were not particularly strong and quite irregular due to the epidural. I had been given tocolytics, which should now be given in higher doses. However, due to my first birth I was so afraid of suffering a labour storm that I refused. The gynaecologist told me that fear was not a good companion and explained to me why she wanted to give me the contraceptive. I was only thinking about a caesarean section, but my friend told me confidently, “You've done so much, you can do it now!". The gynaecologist gave me a little time and suddenly the contractions started to become more regular on their own. I was lying on my back with my legs spread apart on my hips, but the birthing position didn't feel uncomfortable. I held on to my boyfriend and was allowed to push hard with every contraction. The midwife and the gynaecologist motivated me during every contraction and I had complete confidence. I didn't have any strong contractions, but I knew exactly where to push during the night because of the contractions. At some point they told me that I could feel the head if I wanted to. The gynaecologist also said that they might have to use a suction cup soon. But we didn't need that. During the next push, the head suddenly appeared and then the body during the next contraction. It was overwhelming. The placenta also came out without any problems. I thought until the very end that we would have to have a caesarean section after all. My boyfriend and I cried and were incredibly grateful for the great support we had received and were incredibly proud that our son had managed to come naturally after all. My boyfriend cut the umbilical cord and our little boy was allowed to lie on my chest for a long time. The gynaecologist still had to stitch me up and took her time, so we were able to express our gratitude to her again.
From the start of labour to the birth was about 20 hours of pain, despair, hope, gratitude and happiness. Whether the birth was difficult or not doesn't matter to me. I have such positive memories of the birth and am simply grateful that I was able to experience it. I would like to encourage every woman who wants to try the natural way after a caesarean section. For me, it was incredibly important who accompanied me on this journey. I made the right choice with the birthing centre, I was well looked after during pregnancy, during the birth and in the postnatal period and my fears and worries were always taken care of. I learnt an incredible amount from the midwives and was able to take a lot with me. Even though the birth was unplanned and took place in hospital, I am glad that I went down this route and had a much better experience than I did with my first birth.
Thank you for all the loving, human support from start to finish.
